forward head

It is not uncommon for students to show up at our courses aware they have lost several inches of height since their youth. In our culture it is a widely held expectation that you grow up, and then, at some point in later life, start getting shorter again. We all see friends, neighbors, or family members who are on the downward run of this trajectory, and it is virtually common lore that you will “shrink” or stoop in later years.

Losing height in later life is characterized as inevitable in our society. Image from Freepik

Can I expect to lose height as I age?

It is true that trauma, malnutrition, or conditions such as degenerative disc disease or osteoporosis can lead to loss of height. But our experience of working with many thousands of people over the past three decades has shown that most height loss is due to poor posture.

Let’s consider the most common reasons that people lose height:

• A tucked pelvis: The pelvis is actually in its tallest orientation when it is anteverted, which means slightly tipped forward, rather than the commonly advocated “neutral pelvis.” Pelvic anteversion is evident in our infants, our ancestors, and those living in traditional societies today, and is what we teach our students. 

The tucked pelvis (a) is shorter and does not allow the spine to stack well on the sacrum and retain its height. More height is evident in the anteverted pelvis (b). 

• Unhealthy spinal curves: 

Sitting or standing with a tucked pelvis (a.), expect to see the spine adopt a compressive C-shape. This rounding of the back reduces overall height in sitting, standing, and walking. Trying to sit up or stand up straight with a tucked pelvis (b.) takes a lot of muscular tension to maintain and excessively loads the lumbar spinal joints and discs. And it also makes you shorter, not taller! A healthier arrangement (c.) allows the spine to stack in more of a J-shape, formed by a distinct L5-S1 angle, and then ascending with less curvature along the remainder of the spine. This taller spine provides space for the intervertebral joints, discs and nerves.

• A weak inner corset: Weak inner corset muscles allow undue pressure and wear and tear on the tissues, discs, nerves, and bones of the spine. This is a major cause of and contributor to degenerative spinal conditions. All can result in a visible loss of height and thickening around the waist area.
• Unhealthy bending: A lifetime of rounded bending overstretches the dorsal ligaments of the spine and produces excessive kyphosis, or rounding of the upper back—stooped posture.
• Forward head posture: A tucked pelvis and/or rounded upper back projects the neck and head forward. This brings excessive muscle tension and compression in the neck and upper back as the muscles endeavor to hold the head upright. 
• Collapsed foot arches: Loss of the natural arches displace the bones and weaken the tissues of the feet, causing localized problems such as plantar fasciitis, Morton’s Neuroma, and bunions. Height and healthy function can additionally be lost through internal rotation in the knees and hips. 

Most people in our society can expect to live into advanced years—but often with considerable physical and mobility challenges. Retaining or regaining healthy posture is key to remaining free from such disability.

Most of us are taller than we think! 

It is neither inevitable nor natural to lose height as you get older. In fact, we have found that it is possible for most people, including those with degenerative conditions, to regain some height!

For a period in pre-COVID days we diligently measured the height of our students before and after they took their Gokhale Foundations Course. They averaged a height increase of two thirds of an inch (1.7 cm). 

Sometimes people discover that they have stooped for years: through doing desk work in poor furniture; bending poorly; as the result of a physical or mental health crisis; or perhaps since trying to hide growth spurts in adolescence. Many of our students have a sudden awakening to the fact that they are taller than they thought. They report feeling elegant, stronger, and healthier.

Moving like we are meant to, for example using a healthy hip-hinge like these two Portuguese workers, preserves height well into older age.

It always astonished me how students seemed more delighted to measure taller than to get out of pain! Reflecting on this, I think students have often been hopeful that their pain will resolve, but are actually surprised when they find they have recovered long-lost height. For both reasons, I share their joy!

What works to restore healthy height and posture.

Clearly, gaining height doesn't happen within a weekend course through any sort of magical “regrowth”! Nor do you get there by redoubling your efforts to “stand up straight.” But you can make transformational changes by addressing the way in which you align your feet, legs, pelvis, spine, and head. And while many of our students gain an inch or more over time, even a millimeter of regained height can be the change from impinged nerves to a pain-free existence.

Molly, a student who is nearing the end of her online Gokhale® Elements course, just wrote us:

I've been fortunate to have a very active lifestyle these 67 years. As I age, I see some effects of gravity and poor habitual posture showing up. A diagnosis of osteopenia and osteoporosis has me on alert. I was exposed to the Gokhale Method® years ago by a yoga teacher and read Esther's Book 8 Steps to a Pain-Free Back. Now, I see great results from having a one-on-one online Gokhale teacher providing additional tips, cues, and feedback. In my annual check-up last week, I had gained a half inch (1.3 cm) in height! This is great news for my spine! Thank you, Gokhale Method.

Molly used to lock out her knees and sway her back in standing (left). She is making great progress (right) as she softens her knees, aligns and lengthens her spine with a more relaxed lower back and tall neck, and rolls her shoulders back home. 

My colleague Julie Johnson and I offered a special workshop called Women’s Empowerment Through Posture this week and were overwhelmed by the level of registrations and interest in this topic. Aging well without shrinking is one aspect of what we will be covering in our brand new group offering Women’s Empowerment Through Posture. Join us for six one-hour group sessions, in which we will work together to transform your posture to find a new level of confidence, relaxation, comfort, and self awareness—as well, of course, as helping with aches and pains. 

Best next action steps 

If you would like to know how to restore or make the most of your natural height, get started by booking a consultation, online, or in person with one of our teachers. 

You can sign up below to join any one of our upcoming FREE Online Workshops…

This is our fourth blog post in the series where we put popular home exercises under scrutiny to examine how they stack up—or not—against the principles of healthy posture. In this post we are looking at head rotations/circling, an exercise that is often suggested to ease stiffness and mobilize the neck.

Neck pain—causes and solutions

Although not often considered in physical fitness and exercise regimens, the neck frequently becomes a problematic area for people in our culture. At that point, we look to mobilizing, stretching, and strengthening exercises to alleviate pain and stiffness.   

In traditional cultures the neck remains upright and long. It is capable of carrying the weight of the head and additional loads without injury.

The Gokhale Method point of view is that most of our neck problems arise from poor posture. The head and neck tend to drift forward and downward, causing the muscles at the back of the neck to tighten. We then lift our chins up so we can look out ahead of us. The resulting compression becomes a pain in the neck—or a headache—that we can do without. So how can we best avoid or remedy this?

Shortened, tight muscles at the back of the neck (left) are a common cause of neck pain and tension headaches. Positioning the head and neck correctly eases this compression (right).

Remedies to avoid

Tight, short muscles may well have compressed your cervical (neck) vertebrae, and perhaps caused bone spurs or bulging discs. Be especially careful to avoid exercises which take your head into circling movements. These call for extreme flexion (forward), extension (backward) and lateral bends (side), any of which could pinch your nerves and discs. By circling through these movements in rapid succession, the risk is heightened. Performing head rotations (twists) is also commonly advocated, but if done with poor alignment, head twists can also compress tissues in the neck. 

The cervical spine has seven vertebrae which support the skull. Wikipedia

There are many delicate and vital structures within the neck, including nerves, discs, and arteries (front view). Wikipedia

The right approach

You want the principles of Primal Posture™ to guide your head back where it belongs. Appropriate support from the longus colli and other deep muscles of the neck will give the cervical spine the support it needs to align well. This will encourage your outer neck muscles to relax their grip and be gently stretched. Circulation in the area will also get a boost. 

The longus colli muscles attach to the front of the cervical spine. When they contract (shown in red), they cause the neck to straighten and, therefore, lengthen.

If your neck is inflamed, it will benefit from steady, well-aligned exercise that can help to calm things down. The video clip below shows you a healthy way to lengthen tight muscles on either side of your neck. These movements do not overload your cervical discs, crunch your vertebrae, or impinge your nerves. Note that the exercise includes working at various angles to address different fibers within the same muscle.

A healthy exercise for the neck

This healthy neck stretch is from a recent 1-2-3 Move class for our Alumni.

Your checklist for this exercise is:

• Perch on the front of your chair as shown.
• Elongate your neck. Learn how to do this here.
• Reach one arm across to your opposite ear and pull upward.
• Roll open the opposite shoulder and pull that downward, leaning over sideways as you hold the rim of the chair seat. Learn how to roll your shoulders open here.
• Don’t sway. Use your rib anchor. Learn how to use your rib anchor here.
• Listen to some good music! It takes 20–30 seconds for muscles to relax.
• Stretch different muscle fibers—slowly turn your head toward your armpit.

Healthy musculature allows the neck to stack in a tall, more vertical position with the head over the body, not forward.

Address the root cause of your neck pain

People usually think of their neck and any pain there as a separate issue from what is going on in their backs. From the point of view of a posture teacher, a distortion in any part of the spine will have an effect on all other parts of the spine. 

For example, people sitting or standing at a computer with their heads stuck forward may try to address neck pain locally. But the root of the problem is often in the pelvis. If the pelvis is tucked (i.e., with an imaginary tail between the legs), the spine will be curved over into a C shape. You can read more about spine shape here. In this situation, any local effort to draw the neck back is going to be hard to sustain, tense, and ultimately counterproductive. But by positioning the pelvis well, the neck will have the opportunity to stack well. At this point, local work on the neck is able to provide not only symptomatic relief but can also return your cervical spine closer to its primal, healthy structure.

A C-shaped back stresses the lumbar (lower back) discs and is also bad news for the neck.

Join me for a special new one-hour FREE Online Workshop, Posture Remedies for Text Neck,  November 12, 11 a.m. (Pacific Time), and learn helpful suggestions on how to improve the architecture and health of your neck. 

If you would like an expert one-on-one assessment of your posture, including  your neck alignment, you can arrange an Online Initial Consultation or take an in-person Initial Consultation if you have a Gokhale Method Teacher near you.

Hunching over or rounding the upper back is often regarded as a hereditary characteristic. I frequently hear people say, “my back is stooped just like my mother, and her mother had it too.” 

Is a hunched back Nature or Nurture?

I agree that hunching is certainly a family trait—but it is largely a learned one, not inherited. 

We mostly learn our posture from our parents and family members. As we grow up, the role models around us in wider society also hold sway. Unfortunately, in our culture, these are usually pretty poor examples to follow. Our relationship to healthy posture has steadily been eroded over the past one hundred years, as I explain in my book 8 Steps to a Pain-Free Back.

Healthy, open posture, as shown here, was typical in Western societies until the late 19th and early 20th centuries. (Print donated by the Mendocino County Museum to the Gokhale Method Institute’s collection).

While it is true that some people have a greater genetic predisposition to these distortions, e.g., they may have slack ligaments which easily allow them to occur, these changes generally only manifest when a particular area of the body is subjected to sustained and inappropriate loading. When a person retains or relearns healthy posture, genetic predispositions have little opportunity for expression and for distortions to take hold.   

This mother in Burkina Faso positions her head, neck, shoulders, and arms in a way that is harmonious with retaining an upright and mostly flat upper back. Her child is also experiencing healthy posture—his arms and shoulders posterior, his chest open.

This well-meaning mother is unfortunately encouraging her daughter to round her back as she exercises. Pexels

Why does the upper back hunch?

In some respects, developing a rounded back is not dissimilar from developing bunions—both distortions are the body’s adaptation to a lack of support in the right place, and consequent overloading somewhere else. 

Bunions can form when the joint at the base of the big toe repeatedly takes weight that should be in the heel bone. This can be due to wearing a pointed or high-heeled shoe, or simply from habitually standing with weight through the forefoot rather than the heel. 

The upper back rounds when it is made to carry and counterbalance the weight of a forward hanging head, neck, shoulders, and arms. In healthy posture the upper body is supported by a more vertical J-shape alignment of the spine and the deep postural muscles, or “inner corset.” This prevents the spine from collapsing into an S-shape, C-shape, or I-shape. You can read more about spine shape here.

Sir Charles Walker, a British member of Parliament, being interviewed. A tucked pelvis will often result in a rounded upper back and forward head carriage. Channel 4 News (UK)

How to improve rounded, head forward posture

One of the best steps towards finding your J-spine alignment is to realign your head over your body. To develop the deep cervical muscles which counter excessive neck curves, I recommend using the Gokhale™ Head Cushion, which was specifically designed for this therapeutic purpose. It mimics the beneficial effects of head loading, but with a safe amount of weight for people in a society unpracticed in carrying on the head. 

People who carry weight on their head push up against it using their deep neck muscles (longus colli) and inner corset. Their central axis remains tall, with no rounding of the upper spine.

Caution: If you have any neck pain, or suspicion of herniation or other degeneration in the neck, do not do this exercise.

Headloading is a rarely taught but highly effective means of lengthening, strengthening, and aligning the neck, and freeing the upper back.

Upright and open posture is your birthright

By not hunching you can:

• Maintain your full height
• Retain a more youthful appearance
• Avoid muscular pain and tension, especially in the back and neck
• Avoid nerve pain, impingements, and poor circulation in the shoulders and arms
• Encourage the “inner corset” muscles to support and protect the spine
• Avoid compression and degeneration in the spine, including bone, discs, and nerves 
• Reduce your risk of osteopenia and osteoporosis in the spine as the bones receive
  the healthy stress they are designed for
• Enjoy healthier breathing and digestion

Hunching is not an inevitable part of aging

Often people start to notice they are hunching in middle or older age, maybe because it has become more pronounced. Hunching usually starts as a postural habit much earlier in life, yet goes largely unnoticed if there is little stiffness or pain in the area—and it is not yet linked negatively to associations with the aging process. In many traditional cultures people preserve an upright posture well into old age.

A lifetime of seated work does not make hunching inevitable, as the upright posture of this Ecuadorian backstrap loom weaver shows.

This elderly man in Indonesia has retained posterior shoulders and a wide, relatively flat upper back. Unsplash

This elderly farmer from the Yogyakarta region of Indonesia has preserved an open chest and shoulders that rest back. Unsplash

At whatever age you notice rounding in your back, it is important not to see it as inevitably leading to an extreme kyphosis (severe outward curvature) in the upper spine. Sometimes students come to us in dismay, perhaps shocked to have recently seen themselves so hunched in a particular photograph or video. Rather than despair, use this highly pertinent data as a springboard and incentive to return toward the healthy alignment you had as a young child. 

A young girl washes eggs for market near Falls Creek, Pennsylvania, 1940. She inclines slightly forward and lengthens the back of her neck to attend to the task. Her shoulders remain posterior, her chest open—no rounding over! Pinterest

How to mobilize a stiff upper back

In most situations using a suitable roller is my favorite way of mobilizing the upper back. It can ease stiffness in the vertebral joints, soften tight muscles, and improve circulation to the area. To ensure you get all of these up sides and none of the potential downsides from roller work, there are some important guidelines to follow:

• Use a roller that is the right size, density, texture, is non-slip, and robust. The Gokhale™ Roller meets these criteria.
• Rolling needs to be done with a safe technique and healthy postural form, not threaten injury to your back or neck.
• New freedom in the upper back must be balanced with healthy posture to improve muscular tone and alignment. This prevents newly acquired “give” in the area from resulting in further rounding.

Caution: If you have osteopenia or osteoporosis, or suspicion of herniation or other degeneration in your spine, do not do this exercise.

The Gokhale™ Roller has been specifically designed to help you on your posture journey towards a happy, hunch-free back.

How the Gokhale Method resolves hunched posture

Posture education often starts when people analyze their online or in-person Initial Consultation photographs with a teacher. Gokhale Method® teachers have a lot of experience in reassuring people who have a kyphosis (rounded upper back), explaining the mechanisms that got them hunched, and the logical steps they can take to turn this unwanted trajectory around. The Initial Consultation starts the process of students fine tuning their ability to read posture. It can be a revelation. 

Initial education in Gokhale Method techniques and the resulting changes can be rapid. Most students soon realize how amenable to change the arrangement of the skeleton and soft tissue can be. Changes to rounded posture are not only possible, but almost guaranteed as students progress through our in-person Foundations or Pop-up course, or online Elements course.

In the case of bony rigidity that has been in place for decades, we work to get improvement around fixed areas, and to prevent it from getting worse. With persistence and patience, a surprising degree of bony changes can take place over time. As with all body tissue, bone constantly renews itself in response to the way it is arranged and used.

Felicia Grimke, aged 32, was a very hunched and pain-plagued office worker.

Now a Gokhale Method alumna, Felicia continues to enjoy working on healthy posture and is virtually pain-free for the first time in many decades.

Many of our students have generously shared the story of their journey out of hunching and pain. Do be inspired by Felicia Grimke’s recent post on overcoming hunching, How the Gokhale Method Solved my Neck Pain and Transformed my Life, and sign up for one of our free online workshops below.